What matters to you? Understanding and applying the "What Matters to You" approach for patient-centered care

Improving the quality of care and strengthening the partnership between healthcare professionals and patients are major concerns in the healthcare sector. Faced with systems sometimes perceived as dehumanized, initiatives aimed at refocusing care on the individual needs and preferences of patients are emerging and gaining importance. Among these, the international program «What Matters to You? » (WMTY), translated into French as « Qu’est-ce qui est important pour vous ? » (CIPV), stands out for its simplicity and power. This approach, which invites caregivers to ask their patients a fundamental question, has proven to be an essential lever for transforming the caregiver-patient relationship, improving the quality of care, and even positively impacting the quality of work life of professionals. This article explores in depth the philosophy, benefits, implementation, and impact of this approach, which has become a true global movement.

The genesis and significance of "What Matters to You".

The "What Matters to You?" program was born from a desire to refocus care on the patient by recognizing that each individual has unique priorities, preferences, and values that should guide their care. The main idea is simple: by directly asking the question "What matters to you?", healthcare professionals open an essential space for dialogue with their patients. This seemingly innocuous question marks a significant break with a more traditional and sometimes impersonal approach, where the emphasis is often placed on the "real" objectifiable disease, reflected by the question "What's the Matter?" ("What is your health problem?"). The slogan "What Matters to You" is thus an intentional play on words that underscores this shift in perspective, placing the patient and their priorities at the heart of care.

Launched in 2014, the WMTY movement quickly conquered the world, being adopted by healthcare professionals in more than 50 countries and involving more than 2,000 teams. This adoption demonstrates a profound need to rethink the care relationship and promote a truly person-centered approach. Since 2014, an international "What Matters to You" day has been celebrated annually, and since 2025, this date has been set on June 3, highlighting the scale and growing impact of this movement. International networks have been formed, allowing participants to share resources, tools, and experiences to facilitate the local implementation of this approach. In Europe, several national and regional organizations have committed to this dynamic, such as PAQS in Belgium, FHV in Switzerland, IEP in France, as well as regional structures supporting the quality of care and patient safety such as ORAQS 97.1 in Guadeloupe, Qualirel Santé in Pays de Loire, and CAPPS in Brittany. France Assos Santé is also a major player in promoting this approach.

In a post-COVID context where there are significant tensions in healthcare facilities, the WMTY program attempts to reconnect professionals to their primary mission of "caring". The goal is to find a balance between what makes sense for the patient, the teams, and the organization. It is about remembering what motivates professionals to get up each morning to see their patients and colleagues.

The benefits of the "What matters to you?" approach for patients

Adopting the question "What matters to you?" brings many direct and indirect benefits to patients. First, it encourages open communication between caregiver and patient. By inviting the patient to express their priorities, values, and preferences, the caregiver creates a climate of trust conducive to a more authentic and meaningful exchange. This in-depth communication allows the healthcare professional to gain a finer understanding of each patient's specific needs. Beyond clinical symptoms, the question opens the door to aspects of the patient's life that can significantly impact their well-being and how they approach care.

By understanding what really matters to the patient, caregivers are better equipped to offer personalized treatment options, presenting the risks, benefits, and alternatives while taking into account the patient's values. This approach promotes shared decision-making, where the patient is actively involved in choices regarding their health. Feeling heard and considered in their priorities helps to strengthen the patient's sense of control over their own care, which can have a positive impact on their adherence to treatments and their experience of the illness.

In addition, the WMTY approach can improve the quality of care provided by refocusing it on what is most relevant to the patient. For example, a patient might express the importance of maintaining their autonomy at home, which could direct care towards strategies that promote this goal. Another might emphasize the importance of not being cold during a procedure, a simple but significant request for their comfort. Taking these elements into account, often neglected in a purely biomedical approach, contributes to a more humane and satisfying care experience. Patients who feel that their expectations have been taken into account are more likely to have a higher trust score towards caregivers and to recommend the hospital.

The impact of "What Matters to You" on healthcare professionals and QWLCT (Quality of Working Life and Combatting Turnover)

The benefits of "What Matters to You?" are not limited to patients. This approach also has a significant positive impact on healthcare professionals and their Quality of Life and Working Conditions (QLWC). In the post-Covid period, where care teams are under considerable strain, the WMTY program helps reconnect professionals with their primary mission of "caring". By refocusing on patients' priorities, caregivers can rediscover meaning in their work, remembering why they chose this path.

Asking the question, "What is important to you?" and acting accordingly can strengthen the feeling of professional effectiveness and job satisfaction. Professionals feel more valued when they have the opportunity to consider the human dimension of care and personalize their approach. This approach also promotes better communication within teams. Sharing what is important to the patient allows for more coherent and coordinated care. In addition, extending the question to the teams themselves allows hospitals to identify what is essential for caregivers and adapt their organization accordingly, thereby improving well-being at work and promoting team loyalty. Valuing the voice of caregivers and strengthening teamwork are important managerial benefits of this approach. The WMTY program is therefore much more than a patient-caregiver relationship tool; it proves to be a true management and leadership tool focused on QWL.

How to integrate "What matters to you?" into daily practice

The integration of the question "What is important to you?" into daily care practice is based on a simple approach that requires genuine listening and a willingness to act. The method is often summarized as "Ask, listen, do" what matters to the person. Another formulation highlights the "Consider, Inquire, Share, View" (CISV): Consider what matters to the person, Inquire by asking "What is important to you?", Share with the team what is important to the person, and View what can be done.

To facilitate the integration of this approach, it is useful to have a conversation guide offering open questions that encourage the patient to express themselves. These questions can be divided into several categories:

• General questions about the patient's priorities and values: "What's important to you today? What are your priorities right now? Is there anything you're particularly concerned about? What does a good day mean to you?
• Questions about care experience and expectations: "How would you like us to care for you? What positive experiences have you had in the past with the healthcare system? Are there any aspects of your care that you would like to change? How can we make your stay or treatment more comfortable?"
• Questions about personal preferences and well-being: "What activities bring you well-being? How can we respect your habits and values? Do you have any specific needs related to your culture, religion, or beliefs?"
• Questions about communication and patient involvement: "How do you prefer to receive information about your health? When would you like to be involved in decisions concerning your health? Who would you like to be involved in your care (family, friends, carers)? Do you have any concerns or questions about your treatment or care?
• Questions about life goals and projects: "What are your short- and long-term goals? Is there anything you'd like to achieve despite your state of health? What can we do to help you achieve these goals?

It is important to note that the question can be adapted according to the context and the patient. For example, for the elderly, the questioning can be extended to their quality of life, their autonomy and medication safety, based on the concept of the 4 Ms (Matters, Medication, Mentation, Mobility) developed by the Institute for Healthcare Improvement (IHI). Some hospitals inform patients upstream of this approach via an explanatory leaflet to invite them to spontaneously express what matters to them.

Experience shows that patient requests are often very accessible and do not always require significant resources to be met. Sometimes, simple interprofessional coordination may be sufficient to meet an expectation. It is crucial to document patient responses and integrate them into their care plan. Sharing this information within the team ensures comprehensive and coherent care.

"What Matters to You" and PREMs: Complementarities and differences

The "What Matters to You" program can be compared to PREMs (Patient-Reported Experience Measures), which are measures of the experience reported by patients. Although both approaches share a common goal of improving the care experience by taking into account the perception and expectations of patients, they are distinguished by their temporality and mode of application.

Common points:

• Patient-Centered Approach: Both aim to improve the care experience by considering patient perceptions and expectations.
• Continuous quality improvement: WMTY and PREMs enable healthcare facilities to adjust their practices based on patient feedback.
• Valuing patient-caregiver dialogue: WMTY encourages proactive and personalized communication, just as PREMS aims to gather patients' lived experiences.

Differences:

CriteriaWhat Matters to You (WMTY)PREMSMain objectiveIdentify in real time what matters to the patient and adjust care accordingly.Evaluate the patient's experience a posteriori to improve practices.MethodOpen questions in conversation with the patient.Standardized questionnaires after hospitalization or consultation.Usage timeDuring care.After care.UsersCaregivers, doctors, quality teams, management.Patients, quality teams, HAS, health research.FormatInteractive and evolving dialogue.Quantifiable and comparable data between hospitals.

In summary, WMTY is an everyday tool that immediately improves the caregiver-patient relationship by making care more human, while PREMs are an evaluation tool that allows for a systematic and comparative analysis of patient experiences on a larger scale. Ideally, both approaches should be used in conjunction: WMTY to improve the live experience and PREMs to measure and manage the improvement of care over the long term. Questions from tools such as eSatis can be similar to PREMs.

The role of directors and indicators of success

The involvement of management is crucial for the implementation and success of the "What Matters to You?" program within a hospital. Managers have a role of impetus and institutional commitment by integrating the program into the hospital's policy and making it a priority. They can also encourage team mobilization in conjunction with supervisors and support local initiatives.

Team training and awareness are also essential. Directors can implement training on patient-centered communication, organize thematic days, and encourage participation in working groups to adapt the program's tools to the realities of the hospital.

Monitoring and evaluation of results are essential to measure the impact of the program. The implementation of indicators makes it possible to monitor the evolution of the quality of care, patient satisfaction and experience, as well as coordination between the various services. Feedback from teams and user representatives is also important, as is the promotion of good practices and the sharing of successes.

Finally, directors play a role in communication and advocacy by promoting the program to Regional Health Agencies (ARS), the High Authority for Health (HAS), hospital federations, and health networks. Integrating the program into HAS certification and evaluation processes and continuous quality improvement is also an important lever.

Several results and impact indicators can be used to measure the effectiveness of the WMTY program:

1. Indicators of patient experience and satisfaction: Patient satisfaction rate (via PREMS, eSatis), percentage of patients who feel their expectations have been taken into account, change in patient trust score towards caregivers, patient recommendation rate (Net Promoter Score - NPS), number of positive feedbacks on care centered on patient values.
2. Indicators of transformation of professional practices: Rate of use of the question "What Matters to You?" in patient interviews, number of professionals trained in this approach, modification of care plans based on patient responses, rate of caregiver engagement in care personalization actions, number of improvement projects resulting from patient feedback.
3. Organizational and quality of care indicators: Reduction in complaints and claims related to a lack of patient listening, reduction in avoidable adverse events, rate of hospital participation in the program, improvement in certification / HAS evaluation scores related to consideration of patient experience, modification of organizational processes to integrate the WMTY approach.
4. Indicators of caregiver well-being and organizational culture: Rate of participation of healthcare professionals in the initiative, impact on team well-being (stress reduction, improved work environment), reduction in caregiver turnover and absenteeism, improvement in professional satisfaction scores regarding the caregiver-patient relationship.
5. Indicators of innovation and evolution of practices: Number of innovative projects developed from patient feedback, implementation of tools facilitating the collection and use of patient responses, integration of the WMTY program into institutional strategies and quality initiatives.

Initiatives and concrete examples

Numerous initiatives demonstrate the adoption and impact of the "What Matters to You" program around the world. The Federation of Vaud Hospitals (FHV) in Switzerland has integrated this approach since 2019 under the translation "What is important to you?" and organizes awareness-raising activities every year on June 6. In seven FHV hospitals, the question is regularly asked to each patient, leading to active listening and documentation of expectations in the patient file. The FHV's experience shows that the initial fears of professionals regarding unrealistic requests are often unfounded, as expectations are generally very accessible.

In France, QualiREL Santé in the Pays de la Loire region joined the WMTY movement in 2023 and is working on developing an implementation guide and a graphic charter to facilitate its local adoption. A regional working group, including patient partners, has been created to celebrate the adaptation of the question in the region's facilities on June 6, 2025.

In Guadeloupe, ORAQS-97.1 introduced the question translated into Creole as « Ka ki fondal ba-w ? » in 2024 in eight health and medico-social facilities. Awareness tools specific to the local culture have been developed, and a seminar was organized to share experiences. The impact has been notable in terms of engagement of caregivers and patients and the evolution of practices towards greater kindness. The facilitator of a nursing home even testified that this approach had "put a smile back on the residents' faces."

Experiments have also been carried out, such as by theAssociation Melioris Le Grand Feu in Niort, which tested the use of reflective boards in patients' rooms to collect their expectations. This initiative has had a positive impact on the caregiver-patient relationship, and expectations are better taken into account.

These examples illustrate the diversity of contexts and methods of application of the "What Matters to You?" program, but all converge towards a common objective: to put the patient back at the center of care by listening to and taking into account what is truly important to him.

Conclusion

What Matters to You" is a simple yet powerful resource for initiating and strengthening the partnership between patients and healthcare professionals. By asking this fundamental question, caregivers pave the way for more authentic communication, more personalized care and a better understanding of each patient's needs and values. Beyond the benefits for patients, this approach contributes to improving the quality of working life for professionals and reinforcing the culture of "caring" within healthcare establishments. The growing commitment of numerous organizations around the world bears witness to the relevance and impact of this movement, which continues to transform the care relationship towards greater humanity and personalization. What's important to you?

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